# MS. JENNIE'S PLACE INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1265204762
- **Authorized official:** RANDOLPH BRACY (CEO)
- **Authorized official phone:** (407) 274-5405

## Contact information

- **Practice address:** 924 N MAGNOLIA AVE STE 320, ORLANDO, FL 32803-3850
- **Practice address phone:** (407) 496-6673
- **Mailing address:** PO BOX 692286, ORLANDO, FL 32869-2286

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 320600000X | Intellectual and/or Developmental Disabilities Residential Treatment Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 10/27/2023
- **Last updated:** 10/27/2023